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Chandranshu chaudhary-बेबाक़ बातें, chilwaniya motihari, Motihari (2025)

21/08/2025

I often say
Bypass के बाद ज़िंदगी बिल्कुल समान्य हो जाती है

12/08/2025

Conventional CABG vs MICS CABG
In the changing world of cosmetics Surgery is also changing fast. There was a time when the Dictum - Bigger incisions meant Bigger surgeons held high but today size of incision is inversely proportional to the skill of Surgeon.
During medieval periods Only scars people loved on their body were War scars and Love bites but today scars on body are like scars on spirit. Scars are constant reminder of the event and we all will agree that No disease can be a Good memory to be reminded off.
Scars attract questions and it refreshes the memories again.
The world is moving fast to a scarless society where we are not reminded of our painful past.
Therefore Besides the Cosmetic benefits Small incisions have many other benefits which rank higher during decision making.
Small scars fasten the healing, reduces the pain, decreases the hospital stay, reduces the cost of treatment and boosts the patient and families Psychologically.
Having said all that decreasing the size of incision poses many difficulties for the Surgical team.
These difficulties multiplies many folds in Thoracic cavity which is a Bony cage.
The usual relaxation and stretching is of little benefit so the team has to modify its skills and instruments to tackle this problem.
At the same time when Cardiac team is fighting with the working space and instruments it has to ensure that the Quality of surgery is not compromised.
Slowly and gradually Cardiac surgery is evolving from its Traditional incision to MICS for all Cardiac surgeries.
Now coming back to the most common and Technically challenging cardiac surgery CABG , CABG is very common cardiac surgery but it’s at the same time very technically challenging because of the size and site of the anastomosis.
CABG too have evolved with the changing time and demand. It started with On Pump arrested CABG to On Pump Beating heart and now OFF PUMP CABG.
So the first dilemma a Cardiac surgeon has while doing MICS CABG is choosing between Off pump and On Pump CABG. During MICS On pump CABG, the surgery becomes comfortable both for the Surgeon and the patient. The anastomosis is complete and All three vessels can be done easily as manipulation of Heart is easy, while Off Pump CABG during MICS puts many restrictions to the surgeon, he can’t manipulate the heart to bring the vessels closer and in front for anastomoses, so usually Single vessel and Double vessel disease on Left side Patient are chosen, for Right side anastomoses the second incision on Right side is needed which increases the discomfort of the patient post operatively very much and the Surgery time.
Even bad vessels pose great challenges during off pump MICS .
So the decision between On pump and Off pump is vital. Although On pump has many technical advantages over Off pump except the Possible disadvantages of Pump both patients and Surgeons are biased towards Off pump CABG. This biasness forces Them to choose Conventional CABG over MICS.

12/08/2025

A Doubt and A Question
Today I am going to talk about a Doubt and a Question.
My coronary artery disease patients often have a Doubt and a Question .
Doubt they have is
Can they walk again? Can they Exercise again? Their Doubt is genuine because Walking caused symptoms and landed them on my Operating table.
Question is
How much?
How much distance they can walk ? They are afraid of walking and exercising because the Pain Breathlessness they experienced during walking create a Psychological barrier and prevent them from walking again.
For How much time they can Exercise?
Well first taking the Doubt
A coronary artery patient must never stop walking and exercising. For all practical reasons after surgery they are as fit as any other Healthy person. But yes the disease might have caused some damage to their Heart functions which might limit their abilities to exercise like before.
How much? Well they should walk and exercise as much as they can . With time this duration and distance increases.
So never Stop walking or exercising.
I am posting a list of Top athletes who continued their Active Sporting career after Bypass Surgery

NBA legend - Kareem Abdur Jabbar

Soccer player David Ginola

Marathon runner-Harry Landers

Weight lifter - Tyler Reynolds

Ironman triathlon John Hannon

05/08/2025

MBBS in Hindi ( For English scroll down)
हिन्दी भाषा में मेडिकल (चिकित्सा) की पढ़ाई

सरकार के इस सोच से मैं बिल्कुल सहमत हूँ लेकिन ये उतना ही असंभव है जितना कि हिन्दी को पूरे देश में लागू करना। मध्य भारत के कुछ प्रदेशों को छोड़ कर लगभग पूरे भारत में हिन्दी भाषा का विरोध होता है । लोग अंग्रेज़ी सीखना पसंद करते हैं इसके कि उनके बच्चे हिन्दी सीखें। अब इस विरोध में सरकार कैसे हिन्दी को मेडिकल की पढ़ाई का माध्यम बना सकती है ?
ये एक मात्र कठिनाई नहीं है बल्कि हिन्दी भाषा में सारे मेडिकल (चिकित्सा) के मापक किताबों का सही अनुवाद और इसके साथ साथ हिंदी भाषा में नए विश्वसनीय किताबों का लेखन भी एक बहुत बड़ी समस्या है ।
कुछ प्रदेश जैसे कि असम अपने क्षेत्रीय भाषा में भी मेडिकल की पढ़ाई पर जोड़ दे रहे हैं जो कि और भी कठिन है क्यूंकि उन किताबों के रचना के साथ साथ विश्वसनीय किताबों का लेखन , लेकिन इन सबसे बड़ा समस्या ये है कि जो विद्यार्थी हिन्दी या अपने क्षेत्रीय भाषा में मेडिकल की पढ़ाई करेंगे वो दूसरे राज्य में जाकर कैसे कार्य करेंगे ?
ये भी एक सत्य है कि सारी मेडिकल (चिकित्सा) के क्षेत्र में विश्वसनीय शोध विदेशों में हो रहे हैं फिर उन कांफ्रेंस में वर्कशॉप में कैसे भाग लेंगे ?
ऐसी बहुत सारी समस्याएं हैं ।
बहुत बड़ा वर्ग चिकित्सा क्षेत्र में हुए आधुनिक यंत्रों और पद्धितियों के अतिविशिष्ट प्रशिक्षण के लिए भी विदेश जाते हैं , इसमें भी भारी बाद्धा आएगी,
ऐसी कई सारी परेशानियां हैं जिनको सरकार को ध्यान में रखना चाहिए ।
अंग्रेज़ी में पढ़कर उसका हिन्दी और अपने क्षेत्रीय भाषा में परिपालन आसान है परंतु हिन्दी या अपने क्षेत्रीय भाषा में पढ़कर उसका अंग्रेज़ी रूपांतरण आसान नहीं है

Indian Govt and some state Govts are trying to start Medical education in Hindi and their Regional languages. I am in full support of that but before jumping to it Govt must ponder over few points
First Hindi is not even a Pan India language. The opposition to Hindi in large part of India is very stiff and acceptance of English is much better in these places.

Do we have enough authentic books on Medical education in these languages?
Can all the Authentic and Accepted books and literature be translated to them?
It’s a fact the all the authentic research and advances in Medicine are happening in western countries so to learn in Hindi and regional languages and then attend those conferences in English will be another challenge.
It’s much easier to learn in English and practice in different Regional languages in India than learn in Hindi or one Regional language and practice in others.
A large number of Medical graduates go to western countries to learn new advances so it will be another big challenge understanding the same things in English .
There are many such practical problems which must be considered before jumping to Nationalist call and implementing the Hindi as medium of Medical Education.

05/08/2025

MBBS in Hindi ( For Hindi scroll down)
हिन्दी भाषा में मेडिकल (चिकित्सा) की पढ़ाई

Indian Govt and some state Govts are trying to start Medical education in Hindi and their Regional languages. I am in full support of that but before jumping to it Govt must ponder over few points
First Hindi is not even a Pan India language. The opposition to Hindi in large part of India is very stiff and acceptance of English is much better in these places.

Do we have enough authentic books on Medical education in these languages?
Can all the Authentic and Accepted books and literature be translated to them?
It’s a fact the all the authentic research and advances in Medicine are happening in western countries so to learn in Hindi and regional languages and then attend those conferences in English will be another challenge.
It’s much easier to learn in English and practice in different Regional languages in India than learn in Hindi or one Regional language and practice in others.
A large number of Medical graduates go to western countries to learn new advances so it will be another big challenge understanding the same things in English .
There are many such practical problems which must be considered before jumping to Nationalist call and implementing the Hindi as medium of Medical Education.

सरकार के इस सोच से मैं बिल्कुल सहमत हूँ लेकिन ये उतना ही असंभव है जितना कि हिन्दी को पूरे देश में लागू करना। मध्य भारत के कुछ प्रदेशों को छोड़ कर लगभग पूरे भारत में हिन्दी भाषा का विरोध होता है । लोग अंग्रेज़ी सीखना पसंद करते हैं इसके कि उनके बच्चे हिन्दी सीखें। अब इस विरोध में सरकार कैसे हिन्दी को मेडिकल की पढ़ाई का माध्यम बना सकती है ?
ये एक मात्र कठिनाई नहीं है बल्कि हिन्दी भाषा में सारे मेडिकल (चिकित्सा) के मापक किताबों का सही अनुवाद और इसके साथ साथ हिंदी भाषा में नए विश्वसनीय किताबों का लेखन भी एक बहुत बड़ी समस्या है ।
कुछ प्रदेश जैसे कि असम अपने क्षेत्रीय भाषा में भी मेडिकल की पढ़ाई पर जोड़ दे रहे हैं जो कि और भी कठिन है क्यूंकि उन किताबों के रचना के साथ साथ विश्वसनीय किताबों का लेखन , लेकिन इन सबसे बड़ा समस्या ये है कि जो विद्यार्थी हिन्दी या अपने क्षेत्रीय भाषा में मेडिकल की पढ़ाई करेंगे वो दूसरे राज्य में जाकर कैसे कार्य करेंगे ?
ये भी एक सत्य है कि सारी मेडिकल (चिकित्सा) के क्षेत्र में विश्वसनीय शोध विदेशों में हो रहे हैं फिर उन कांफ्रेंस में वर्कशॉप में कैसे भाग लेंगे ?
ऐसी बहुत सारी समस्याएं हैं ।
बहुत बड़ा वर्ग चिकित्सा क्षेत्र में हुए आधुनिक यंत्रों और पद्धितियों के अतिविशिष्ट प्रशिक्षण के लिए भी विदेश जाते हैं , इसमें भी भारी बाद्धा आएगी,
ऐसी कई सारी परेशानियां हैं जिनको सरकार को ध्यान में रखना चाहिए ।
अंग्रेज़ी में पढ़कर उसका हिन्दी और अपने क्षेत्रीय भाषा में परिपालन आसान है परंतु हिन्दी या अपने क्षेत्रीय भाषा में पढ़कर उसका अंग्रेज़ी रूपांतरण आसान नहीं है

04/08/2025

Let’s Talk about Hypertension today

I don’t call Hypertension a disease but only a Symptom like Fever.
I categorise Hypertension into three categories

First - as Complications of Life style altercation which is the most common one

Second- as part of Ageing process where the culprit is Narrow atherosclerotic stiff vessels

Third - as secondary to some systemic diseases like CKD, Endocrinology etc

Whenever a patient comes with the complaint of Hypertension I categorise him accordingly and then the Management becomes easy

For First category the First line is Life style Modifications, Stress management Exercise, Diet
For second Category it’s combined
And for Third category it’s Mostly Medication with Life style changes ,

03/08/2025

For a Doctor best earning is the Trust of His patients and People

It’s been 5yrs leaving MOTIHARI but still people from There call me to consult and some Even come all the way to Delhi to seek Physical Consultation from me.
These calls and consultations are the Most precious thing for me.
I feel humbled that people Trust my Medical Acumen and Knowledge.

02/08/2025

Work life balance among Indian Doctors
It’s time doctors in India start considering Work life balance. There was time when numbers were less so long working hrs were somehow justified (not actually) but now that we have ample numbers it’s time Doctors start considering work life balance for themselves.
At the end of their careers I’m Honest self evaluation Most doctors will find themselves to be not More than an ATM for their families. They have missed PTMs, Birthdays, Anniversaries Kids Vacations etc etc. why because they were busy in Hospitals.
They have often been blackmailed in the name of Service to Sick ignoring their own Mental and physical health.
In India Almost every doctor works 24*7 whole year .
The result is that almost every Doctor’s Kid denounce to follow their parents footsteps and become Doctors.
Medical field is more a repulsion for them than a Motivation to join because they have seen their parents working late hrs and missing Play time , bedtime stories and family holidays.
This needs to be changed.
The average life span of Doctors are less than the normal population because of Extremely high Stress levels they experience during their careers.
This trend is same every where from small towns to Metros, Self owned clinics to Corporate Hospitals which must be changed and only. Hospital administrators must keep enough doctors for replacement.
All the studies point towards the same .

01/08/2025

I won’t promise you a CHEAP treatment
But I can assure you of Best Treatment at Lowest cost

31/07/2025

A lion is mightiest in Jungle
An Eagle is Strongest in Sky
An Elephant is Strongest on Land
A Crocodile os Moghty in Water
We all have our Territory where we give our Best

29/07/2025

SDH- Smoking Diabetes and Hypertension are three enemies of Heart (Cardio-Vascular system)
Good thing is all three can be controlled by Healthy Habits

27/07/2025

Tension Pneumothorax- an Emergency

Presentation , Diagnosis and treatment

Tension pneumothorax is an Emergency and every clinician must be able to diagnose it clinically because by the time Radiological Evidence comes it might be late .
Tension Pneumothorax Is a Clinical diagnosis.
Many a time clinicians miss it because they don’t anticipate it . And more they try to manage Respiratory distress worse it become

Symptoms-
Respiratory distress
Hypotension
Bluish Cyanosed patient
Sharp pleuritic chest pain

Sings-

No chest wall movement on affected side with Respiration
Deviated Trachea to opposite side
Hyper resonance on affected side
Absent Breath sound on affected side
Tachycardia
Tachypnoea
Central Cyanosis
Distended Jugular vein

Before asking for Radiological confirmation one must go for Needle Decompression which relieves the symptoms magically .
CXR-
Dark field
Absent bronchial margins
Deviated Trachea
Deviated mediastinum

It is caused by bursting of some Bulae into the pleural cavity which create a Ball and valve type opening pushing air into pleural cavity which create a positive pressure inside. With every breath more and more air is pushed and keeps accumulating making it progressively worse.
Common among TB patients , Young males , Smokers. It can be Traumatic.
Usually is preceded by a violent bout of Cough with sharp pleuritic pain.

Water seal ICD tubes relieve the symptoms.
Surgical intervention is rarely needed.

Chandranshu chaudhary-बेबाक़ बातें

21/08/2025

12/08/2025

12/08/2025

05/08/2025

05/08/2025

04/08/2025

03/08/2025

02/08/2025

01/08/2025

31/07/2025

29/07/2025

27/07/2025

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